Visual disturbance and urgent appointment - advice please

[lucy65]

Hi

Ive not posted on here for a while since I was diagnosed with PMR (aged 51) in March and got invaluable support and advice from you then, so I'm back looking for more please!

In the meantime I have found this an ongoing source of support even though Ive not been actively involved.

In general things have been going well for me. I am tapering in accordance with PMRPRO guidelines (just down to 13 from 15 in March) and I have made lots of adjustments in my life which include : emotional- letting go of being emotionally responsible for others, physical - doing regular pilates etc and making dietary changes - understanding types of foods to avoid with auto immune conditions because they increase inflammation such as gluten. I'm also in the middle of a book called 'The Immune system recovery plan' by Susan Blum. I'm only half way through it and dont know what the outcome will be but I'm finding it really useful so far.

So my reason for the post...............over the past couple of days I noticed a new black floater which at first I though was a fly, then realised it was a floater. Since then I now have more of the 'flies' but more significantly what I can only describe as being like a spidery false eye lash that moves across my vision in one eye with a tad pole type movement. its not blocking my vision but I am very aware of it moving across and generally starting from my peripheral vision. Im aware of the risk of GCA but not sure if this is 'typical' of the vision symptoms associated with GCA. I don't have any pain or headaches and feel quite well in myself. Yesterday I googled floaters and the symptoms I had led me to possible Uveitis and that also said was common with people who have an auto immune condition.

I was very fortunate to get a GP appt this morning (particularly after bank holiday weekend!) and he knew of PMR and risk so immediately called the local urgent eye clinic and I now have an appt for them tomorrow.

At this stage I don't know what this is but wondered whether this sounded similar symptoms to people who have been diagnosed with GCAor Uveitis? Also wondered are there any specific questions etc I need to be asking at the appt tomorrow to make sure action is taken quickly if necessary.

Many thanks in advance

[PMRpro Ambassador]

I have a large floater which appeared in the early days of PMR. It improved at higher doses of pred (I think at least) but my optician was never concerned about it - didn't know where it might have come from though. If I screw up my eyes it disappears.

I think it is difficult to say there is a "typical" GCA effect, they vary greatly. The general impression you give though is not one of GCA - but I'd never say never and haven't had it myself so who knows.

But you are going to the right place tomorrow and I would think they will be pretty aware. Ophthalmologists are much more on the ball with GCA risk than rheumies usually - probably because they are far more conscious of the tragedy of loss of vision - and more likely to use higher doses of pred.

Do tell us how you get on.

[lucy65 in reply to PMRpro]

Thanks so much for your very quick response and guidance. I will update after tomorrow.

[Celtic PMRGCAuk volunteer]

Lucy, I doubt this is in any way due to GCA, but you are very wise to seek expert advice.

Of course, because of our experience with GCA, that can always pose a question at the back of our minds but as far as any sudden appearance of a problem with our eyes is concerned, it is vital to seek urgent advice as there are many possible causes and some of them potentially serious.

For instance, a few years ago our son didn't realise that a problem with his vision was, in fact, caused by a stroke (clot to the brain) and by the time he sought advice and the necessary treatment it was too late to rectify the problem with his vision sufficiently to continue being able to drive. A friend of mine rang one day saying she had a feeling of a curtain over one eye, querying whether she might have GCA - it turned out to be a detached retina. Another caller, also querying GCA, said he was waking up from an afternoon doze with blurred vision - he, too, had suffered a stroke.

I do apologise if this sounds unduly dramatic, and I don't wish to scare anyone, but just wanted to impress on everyone that eye problems are not necessarily due to GCA and that immediate advice should be sought to rule out other potentially serious conditions.

As far as any questions you should ask at your appointment tomorrow, just ensure that the doctor is aware of the fact that you are on steroids for PMR, that is linked to GCA. S/he should then carry out a thorough investigation of the back of your eyes with all the right equipment, and, hopefully, all will be well. Good luck!

[lucy65 in reply to Celtic]

Thanks so much for your very quick response too. And the alternatives detached retina also sounded similar and a possibility. I'm sorry to hear about your son, I hope he is doing OK. I will update after my appointment.

[David_H]

Hi, I've had floaters all my life so quite used to them. They are harmless but a bit of a pain at first. It could be a posterior vitreous detachment (PVD). As you get older the various structures that make up your eye change; this includes your vitreous gel. The vitreous is made up mainly of water and collagen and it has a stiff, jelly-like consistency. As you age the vitreous becomes more watery, less jelly-like and isn't able to keep its usual shape. As a result, it begins to move away from the retina at the back of the eye towards the centre of your eye. Best get it checked out though. Cheers Dave

[lucy65 in reply to David_H]

Thanks Dave that sounds reassuring. Hopefully it will just be a getting older thing! I will post an update tomorrow.

[lucy65]

Following my post yesterday just to update following my appt at urgent eye clinic. It turned out that I had a tear in my retina and ended up having laser surgery immediately! That wasn't what I was expecting but very grateful it was detected and treated so quickly. Apparently that potentially can turn into a detached retina which is far more serious. I asked about how do we know if floaters are serious or not, and he said there's no way of knowing without them being checked. It may then only come to light if its becomes something serious. So my message to everyone is if you have new floaters or anything eye related, definitely worth getting it checked out. The ironic thing is that this wasn't PMR related, but I'm sure it helped me get such a quick response from the GP and eye clinic. So thanks PMR!

Excellent service from the NHS!

[Shastring]

Hi Lucy,

I went to see a Neuro Opthomologist who specializes in GCA as I had problemsswith blurriness and overall problems in eyes. My optic pressure was slightly elevated, common side effect of the pred. Good thing you acted so quickly. Good luck.

Sharon

[lucy65 in reply to Shastring]

Thanks Sharon, only just saw your reply! Didn't know about the pred side effect so that's good to know. All the best to you too.